Wuxiang Shi

Introduction: Disparities in healthcare resource allocation present a significant challenge in China, particularly in underdeveloped western regions like Guangxi. Moving beyond analyses of isolated factors, this study investigates the complex, synergistic interactions of socioeconomic, governmental, and demand-side conditions that shape allocation efficiency. Methods: We employed a two-stage, mixed-methods approach. First, Data Envelopment Analysis (DEA) evaluated the relative efficiency of 14 prefecture-level cities in Guangxi, using healthcare personnel and hospital beds as inputs, and outpatient visits and hospital discharges as outputs. Second, Fuzzy-Set Qualitative Comparative Analysis (fsQCA) was used to identify configurations of conditions (including per capita GDP, urbanization, government expenditure, and per capita health spending) leading to high or low efficiency. Results: The overall efficiency of healthcare resource allocation in Guangxi was suboptimal (mean score: 0.364), with significant regional disparities. The fsQCA revealed multiple, equifinal pathways to outcomes, demonstrating causal asymmetry. We identified four configurations for high efficiency (solution consistency: 0.809; coverage: 0.771), where robust socioeconomic development (per capita GDP, urbanization) was a core condition in most paths. Conversely, seven configurations led to low efficiency (solution consistency: 0.876; coverage: 0.733), often characterized by insufficient government support or socioeconomic development, even when other factors like health demand were high. Discussion: Our findings indicate that healthcare resource allocation efficiency is shaped by the synergistic interaction of multiple conditions rather than any single factor. This configurational perspective explains the stark regional disparities, with ethnic minority areas being particularly vulnerable due to unfavorable condition profiles. We recommend tailored, place-based policies, such as strengthening primary care, promoting “Internet + Healthcare,” and establishing regional medical centers, to create synergistic effects and optimize resource allocation.

Purpose: This study aims to survey the demographic status of aesthetic plastic surgeons in an economically developed region and to investigate their continuing training needs in contents, training methods, and barriers in private and government hospitals. Methods: A cross-sectional survey with a self-administered questionnaire was conducted from January to December, 2022 in Guangdong, China. In-depth interviews were conducted with key informants to gain insights on the current demographic status. Demographic data and training needs assessment were collected and compared with the chi-square test, Fisher’s test, Mann-Whitney U-test using R software. Results: The disparity of surgeons’ demographic data between private and government hospitals was small. Over 60% of practicing aesthetic plastic surgeons transferred from other specialties, and one third of them had less than three years of working experience. Half of surgeons attended training less than three times with an affordable expense of 1000-5000RMB. Almost 80% of them had strong willingness to attend a continuing training program. They prefer to attend further study in a tertiary hospital, with a short topic-focused training course and operation demonstrations. Their favorable training contents were rhinoplasty, eye surgery, and new technologies. Our questionnaire survey revealed the likelihood that the surgeons had a graduate degree in government hospitals outweighed those in private hospitals (P<0.05). Results also showed that the government hospitals focused more on repair and reconstructive surgery and academic research, whereas, private hospitals focused on market needs and were more profit-driven, where the organizational needs had influence on their different training needs for aesthetic plastic surgeons. Conclusion: It would be favorable to take the demographic status of aesthetic plastic surgeons and organizational needs into consideration in designing a continuing training program in plastic surgery.

Purpose: This study aims to survey the demographic status of aesthetic plastic surgeons in an economically developed region and to investigate their continuing training needs in contents, training methods, and barriers in private and government hospitals. Methods: A cross-sectional survey with a self-administered questionnaire was conducted from January to December, 2022 in Guangdong, China. In-depth interviews were conducted with key informants to gain insights on the current demographic status. Demographic data and training needs assessment were collected and compared with the chi-square test, Fisher’s test, Mann-Whitney U-test using R software. Results: The disparity of surgeons’ demographic data between private and government hospitals was small. Over 60% of practicing aesthetic plastic surgeons transferred from other specialties, and one third of them had less than three years of working experience. Half of surgeons attended training less than three times with an affordable expense of 1000-5000RMB. Almost 80% of them had strong willingness to attend a continuing training program. They prefer to attend further study in a tertiary hospital, with a short topic-focused training course and operation demonstrations. Their favorable training contents were rhinoplasty, eye surgery, and new technologies. Our questionnaire survey revealed the likelihood that the surgeons had a graduate degree in government hospitals outweighed those in private hospitals (P<0.05). Results also showed that the government hospitals focused more on repair and reconstructive surgery and academic research, whereas, private hospitals focused on market needs and were more profit-driven, where the organizational needs had influence on their different training needs for aesthetic plastic surgeons. Conclusion: It would be favorable to take the demographic status of aesthetic plastic surgeons and organizational needs into consideration in designing a continuing training program in plastic surgery.

Background: Postpartum depression (PPD) is the most common mental illness affecting women during lactation, and good social capital is considered a protective factor. This study aimed to investigate PPD symptoms, and explore the relationships between social capital and PPD symptoms of lactating women in southwest minority areas in China.Materials and methods: This cross-sectional study was conducted among 413 lactating women in Guangxi, China. Data were collected using the Edinburgh Postnatal Depression Scale and the Chinese version of the Social Capital Assessment Questionnaire. Hierarchical regression analysis was conducted to explore the factors influencing PPD symptoms, and a structural equation model was used to examine how social participation and cognitive social capital mediated PPD symptoms.Results: The total prevalence of PPD symptoms (score > 12) was 16.46%, and that of mild depression symptoms (9–12 score) was 22.03%. Nine variables predicted PPD symptoms and explained 71.6% of the variance in the regression model: higher age, lack of medical security, fixed occupation, breastfeeding time, self-caregiver, maternity leave, social participation, social trust, and social reciprocity. Furthermore, cognitive social capital mediated the relationship between social participation and PPD symptoms, with a mediation effect rate was 44.00%.Conclusion: The findings of this study highlight that social capital, support from family members, maternity leave, and medical insurance play protective roles in the PPD symptoms of lactating women. It is necessary to improve social capital as a key strategy for interventions for PPD symptoms, and active social participation activities are critical to reducing PPD symptoms among lactating women in minority areas.

Background Controlling hygienic risk exposures (HREs) is important for reducing acute respiratory infection or parasitic infection; however, studies across vulnerable ethnicities are limited. This study aimed to identify the prevalence and associated factors of HREs and perception on HRE policies among ethnic groups in Guangxi, China. Methods A community-based cross-sectional study was conducted in rural areas of Guangxi, China, among Han majority and Zhuang, Yao, Miao, Dong, Mulao, and Maonan minorities. The prevalence of HREs and perceptions concerning the HRE policies were presented using descriptive statistics. Associated factors were analyzed using a logistic regression model, and adjusted prevalence ratios and 95% confidence interval were calculated. Results High prevalence of HREs on hand and soil hygiene were found in all ethnicities. Miao minority had the highest prevalence of HREs, particularly in poor hand washing (74.1%), infrequent nail clipping (90.4%), and outdoor soil contact (92.7%), compared with the others. Prevalence of HREs in some ethnic minority groups were significantly different from those in Han majority after adjusted with other significant factors. Village leaders were more aware of existing national and community regulations related to HREs than household heads. Village leaders and household heads of almost all ethnic groups perceived high policy’s compliance in their village or household on avoiding fertilizing with farmyard manure. Conclusions HREs were prevalent in all ethnic groups, especially in Miao minority. Ethnicity, one of social determinants, was significantly associated with HREs. Raising awareness at both the village and household levels on HREs is needed for all ethnic groups.

BACKGROUND The aim of our study was to elucidate the biological targets and pharmacological mechanisms for calycosin (CC) against colorectal cancer (CRC) through an approach of system pharmacology. MATERIAL AND METHODS Using a web-based platform, all CRC-causing genes were identified using a database of gene-disease associations (DisGeNET), and all well-known genes of CC identified using the databases of prediction of protein targets of small molecules (Swiss Target Prediction), drug classification, and target prediction (SuperPred). The carefully selected genes of CRC and CC were concurrently constructed by using a database of functional protein association networks (STRING), and use of software for visualizing complex networks (Cytoscape), characterized with production of protein-protein interaction (PPI) network of CC against CRC. The important biological targets of CC against CRC were identified through topological analysis, then the biological processes and molecular pathways of CC against CRC were further revealed for testing these important biotargets by enrichment assays. RESULTS We found that the key predictive targets of CC against CRC were estrogen receptor 2 (ESR2), ATP-binding cassette sub-family G member 2 (ABCG2), breast cancer type 1 susceptibility protein (BRCA1), estrogen receptor 1 (ESR1), cytochrome p450 19A1 (CYP19A1), and epidermal growth factor receptor (EGFR). Visual analysis revealed that the biological processes of CC against CRC were positively linked to hormonal metabolism, regulation of genes, transport, cell communication, and signal transduction. Further, the interrelated molecular pathways were chiefly related to endogenous nuclear estrogen receptor alpha network, forkhead box protein A1 (FOXA1) transcription factor network, activating transcription factor 2 (ATF2) transcription factor network, regulation of telomerase, plasma membrane estrogen receptor signaling, estrogen biosynthesis, androgen receptor, FOXA transcription factor networks, estrogen biosynthesis, and phosphorylation of repair proteins. CONCLUSIONS Use of system pharmacology revealed the biotargets, biological processes, and pharmacological pathways of CC against CRC. Intriguingly, the identifiable predictive biomolecules are likely potential targets for effectively treating CRC.